title: [Antiphospholipid syndrome in nephrology. Kidney damage and practical aspects of the management].
abstract: The antiphospholipid syndrome is a thrombophilia characterized by the combination of arterial and/or venous thrombotic events or obstetric clinical events, associated with persistent presence of antiphospholipid antibodies. In this syndrome, thromboses may affect all of the vascular tree, renal damage is frequently associated with a specific antiphospholipid syndrome nephropathy. We propose in this review to provide updated recommendations on the management of antiphospholipid syndrome in nephrology. Treatment is based on long-term anticoagulant therapy with or without antiplatelet agents according to clinical events. The use of a conventional nephroprotection must not be forgotten (strict control of blood pressure with drugs blocking the renin-angiotensin-aldosterone system). Catastrophic antiphospholipid syndrome is an extremely severe complication which can threaten the vital prognosis of the patient. This justifies particular surveillance, as well as prevention in high-risk situations. We also illustrate the difficulties of long-term management in these patients, both in dialysis or kidney transplantation.
authors.affiliation: Service de néphrologie-hémodialyse-transplantation, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France. Electronic address: manondekeyser@gmail.com.
authors.forename: Manon
authors.initials: M
authors.lastname: Dekeyser
authors.affiliation: Service de médecine vasculaire, centre de compétence régional des maladies vasculaires rares et systémiques et auto-immunes, institut lorrain du cœur et des vaisseaux Louis-Mathieu, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France; Inserm UMR_S 1116, Nancy University, 54000 Nancy, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Zuily
authors.affiliation: Laboratoire d'anatomopathologie, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Champigneulle
authors.affiliation: Laboratoire d'hématologie biologique, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Eschwège
authors.affiliation: Service de néphrologie-hémodialyse-transplantation, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Frimat
authors.affiliation: Pôle de gérontologie-soins palliatifs, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Perret-Guillaume
authors.affiliation: Service de médecine vasculaire, centre de compétence régional des maladies vasculaires rares et systémiques et auto-immunes, institut lorrain du cœur et des vaisseaux Louis-Mathieu, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France; Inserm UMR_S 1116, Nancy University, 54000 Nancy, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Wahl
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000276:immunology; D001157:Arterial Occlusive Diseases / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D001706:Biopsy; D002318:Cardiovascular Diseases / Q000209:etiology; D000075202:Contraindications; D019468:Disease Management; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control / Q000628:therapy; D016030:Kidney Transplantation; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012077:Renal Artery / Q000473:pathology; D012079:Renal Circulation; D006435:Renal Dialysis; D012082:Renal Veins / Q000473:pathology; D013921:Thrombocytopenia / Q000209:etiology; D019851:Thrombophilia / Q000188:drug therapy / Q000209:etiology*; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D057049:Thrombotic Microangiopathies / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D000959:Antihypertensive Agents; D010975:Platelet Aggregation Inhibitors
keywords: Antiphospholipid syndrome; Antiphospholipid syndrome nephropathy; Dialyse; Dialysis; Néphropathie associée au syndrome des antiphospholipides; Syndrome des antiphospholipides; Traitement; Transplantation; Treatment